Legislature(2017 - 2018)GRUENBERG 120

04/13/2018 01:00 PM JUDICIARY

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Recessed to a Call of the Chair --
+ SJR 4 AK LEGALLY ACQUIRED IVORY USE EXEMPTION TELECONFERENCED
Heard & Held
+ HB 54 TERMINALLY ILL: ENDING LIFE OPTION TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HJR 38 AK RAILROAD TRANSFER ACT; CONVEYANCES TELECONFERENCED
Moved HJR 38 Out of Committee
           HB  54-TERMINALLY ILL: ENDING LIFE OPTION                                                                        
                                                                                                                                
6:29:54 PM                                                                                                                    
                                                                                                                                
CHAIR  CLAMAN announced  that the  final only  order of  business                                                               
would be  HOUSE BILL NO.  54, "An  Act relating to  the voluntary                                                               
termination of life by terminally  ill individuals; and providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
6:30:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HARRIET   DRUMMOND,  Alaska   State  Legislature,                                                               
acknowledged that the subject matter within  HB 54 is not an easy                                                               
subject for most  people.  Death is a difficult  topic because it                                                               
is raw  and emotional, and  no one wants to  lose a loved  one or                                                               
think about  leaving their family behind.   No one likes  to talk                                                               
about (audio  difficulties) painful and the  legislature needs to                                                               
change that  situation.  This  legislation allows  terminally ill                                                               
patients to ease their pain  and suffering by allowing doctors to                                                               
prescribe medication to offer aid  in dying, it allows an Alaskan                                                               
the right to  live and die on their own  terms according to their                                                               
own desires  and beliefs.  Death  is a natural part  of life, and                                                               
this bill  gives people  dignity and peace  of mind  during their                                                               
final days with family and loved  ones.  It places a much greater                                                               
focus on a person's life than  on the often painful and agonizing                                                               
process of dying, she offered.                                                                                                  
                                                                                                                                
6:32:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DRUMMON acknowledged that  she had introduced this                                                               
legislation  several years  ago  because Brittney  Maynard was  a                                                               
newlywed, age 29, living in  California, she was happy and bright                                                               
and  looking forward  to a  long  and successful  life.   Shortly                                                               
after Ms.  Maynard was  married, she was  diagnosed with  a brain                                                               
cancer known to  be swift and painful, it could  not be repaired,                                                               
healed,  or  taken  care  of  by  chemotherapy.    The  State  of                                                               
California did  not have a medical  Aid in Dying law  in place at                                                               
the time  so she decided to  take herself and her  new husband to                                                               
Oregon to take  advantage of the state's Death  with Dignity law.                                                               
Ms. Minard's widower and her  parents then proceeded to work with                                                               
California's  legislators until  the  law was  passed last  year.                                                               
Representative Drummond  said that she thought  about Alaskans in                                                               
similar  situations, isolated  far from  the rest  of the  United                                                               
States,  and she  could not  imagine someone  enduring a  fragile                                                               
medical condition at the end of  their life and not being able to                                                               
take  advantage of  this choice  if that  was their  desire.    A                                                               
desire to die  at home with family and friends  close by, and not                                                               
be  required to  pick up  everything  and move  to an  unfamiliar                                                               
location  thousands of  miles away  from their  home in  order to                                                               
have some control over the last days of their lives, she said.                                                                  
                                                                                                                                
6:34:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DRUMMOND  reiterated that this is  the second time                                                               
she has introduced  this legislation and many  people have strong                                                               
opinions  about  this  bill.     She  noted  that  during  public                                                               
testimony,  family members  will testify  as to  how they  had to                                                               
deal with  things, and  "I hope  and pray none  of you  will ever                                                               
have to deal with."  She advised  that she has been told that she                                                               
is evil for  introducing this bill, she is going  to hell, she is                                                               
a Nazi,  and told she  is playing  God.  Terminally  ill patients                                                               
are  hooked  up to  countless  machines  that prolong  death  for                                                               
weeks,  there are  machines that  can breathe,  eat, urinate  for                                                               
people,  and  CPR  is  administered   on  sick  patient's  (audio                                                               
difficulties) swollen,  bleeding, airways.   (Audio difficulties)                                                               
be  able to  help  people.   Representative  Drummond stated  the                                                               
following:                                                                                                                      
                                                                                                                                
                                                                                                                                
     I have  been told that by  introducing this legislation                                                                    
     I am  promoting suicide.   I resent that and  I'm going                                                                    
     to get  ahead of this  game.   My son was  a sensitive,                                                                    
     caring, athletic  17-year old the  day he took  his own                                                                    
     life.  Steven was my  oldest child, he loved biking and                                                                    
     snowboarding.  He  biked to Denali when he  was just an                                                                    
     8th  grader.   I  have  spent  years going  over  every                                                                    
     minute of  the days leading  up to  his death.   I have                                                                    
     agonized  over  every  decision,   every  word  I  said                                                                    
     wondering  if there's  anything  I could  have done  to                                                                    
     prevent it.   There  isn't a  day that  goes by  when I                                                                    
     don't think  about how old he  would be now or  what he                                                                    
     might be  doing if he  was alive  today.  Suicide  is a                                                                    
     tragedy,  an   irrational  self-destructive   act  that                                                                    
     should  be prevented  at all  costs.   We don't  get to                                                                    
     pick and  choose which  deaths we  want to  be suicide.                                                                    
     Does  a patient  who  decides to  quit chemotherapy  or                                                                    
     stop  undergoing  lifesaving  dialysis after  years  of                                                                    
     slow  deterioration count  as suicide?   Does  a Marine                                                                    
     who is  under attack and  jumps on  a bomb to  save his                                                                    
     fellow soldiers  count as  a suicide?   Does  a Jehovah                                                                    
     Witness who refuses a blood  transfusion because of her                                                                    
     religious beliefs  count as  a suicide?   Suicide  is a                                                                    
     healthy person who  could live, but wants to  die.  Aid                                                                    
     in Dying is about a sick  person who wants to live, but                                                                    
     is dying.                                                                                                                  
                                                                                                                                
6:36:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  DRUMMOND explained  that this  legislation allows                                                               
patients to  have important end-of-life discussions  with doctors                                                               
that  they already  know  and trust.    Without this  discussion,                                                               
well-meaning   doctors  are   faced   with  prescribing   painful                                                               
procedures, even when  the patient does not want  them, and there                                                               
is  little hope  for success.   People  in these  conditions have                                                               
often lost their health and oftentimes  much more.  This bill, at                                                               
least, gives  a patient control  for the last and  most important                                                               
decision they have  left.  Seven states and  Washington D.C. have                                                               
all legalized  Death with  Dignity and those  states have  seen a                                                               
dramatic decrease in suicide attempts  by the terminally ill, she                                                               
explained.   Alaskans  should  be  not forced  to  make a  choice                                                               
between  living out  the  rest of  their life  in  misery with  a                                                               
terminal  illness  or taking  their  own  life  in a  brutal  and                                                               
inhumane  manner.   She  urged  the  committee's support  in  the                                                               
passage of this bill to give  an end-of-life choice to the person                                                               
it will affect most.                                                                                                            
                                                                                                                                
6:38:50 PM                                                                                                                    
                                                                                                                                
CHAIR CLAMAN opened public testimony on HB 54.                                                                                  
                                                                                                                                
6:39:26 PM                                                                                                                    
                                                                                                                                
ELLA SALTONSTALL,  Volunteer, (Audio  difficulties) and  is fired                                                               
up to lead  this cause.  She explained that  she is testifying to                                                               
advocate for those (audio difficulties),  and she would like that                                                               
to  be  a  possibility  for  terminally  ill  Alaskans.    (Audio                                                               
difficulties) she offered  that it is so people  will not suffer,                                                               
and their  reply is  "Well, of course  they shouldn't  suffer and                                                               
this is about (audio difficulties)."  (Audio difficulties.)                                                                     
                                                                                                                                
6:43:21 PM                                                                                                                    
                                                                                                                                
MARGARET  DORE,  Attorney,  President,  Choice  is  an  Illusion,                                                               
advised  that  the State  of  Washington  passed the  Death  with                                                               
Dignity Act  into law, and she  warned the committee to  not make                                                               
Washington's mistake.   She  noted that she  is the  President of                                                               
Choice is  an Illusion  which is opposed  to assisted  suicide in                                                               
euthanasia.  She  said that she prepared an analysis  to the bill                                                               
and she had  other handouts for the committee.   One of the first                                                               
things to understand is that  the discussion is not talking about                                                               
people  who are  necessarily dying  anytime soon,  the law  has a                                                               
broad  reach   as  currently  written.     For   example,  (audio                                                               
difficulties)  because the  criteria  is six-months  to live  and                                                               
that  is determined  by  (audio  difficulties).   As  far as  not                                                               
causing  suicide,  she  said  she has  had  three  health  (audio                                                               
difficulties) one of  them told her later that she  had saved his                                                               
life, these are  traditional suicide.  The other  issue is (audio                                                               
difficulties).    Aid   in  Dying  is  a   traditional  term  for                                                               
euthanasia and  she first saw the  term being used in  a State of                                                               
Iowa law  review.  She advised  that there has been  push back in                                                               
other   states,  this   year  in   the  State   of  Utah   (audio                                                               
difficulties).                                                                                                                  
                                                                                                                                
6:47:11 PM                                                                                                                    
                                                                                                                                
MARY MCDOWELL advised that sometimes  what is far less manageable                                                               
than the  physical pain that  a terminally ill person  suffers is                                                               
their  fear and  anguish.   She said  that it  is not  just about                                                               
death itself, but about the process  of dying and what that might                                                               
entail.   For some people, some  of that fear and  anguish can be                                                               
relieved by just knowing that they  have the option to make their                                                               
own  decision to  not  endure  any additional  hours  or days  of                                                               
suffering if and  when they reach the point where  they are ready                                                               
and want  it to end.   One of  the most compelling  arguments for                                                               
her in favor of this legislation  is the fact that in states with                                                               
similar laws in  place, a large percentage of  the terminally ill                                                               
people  who choose  to obtain  the prescription  for life  ending                                                               
medication ultimately end up choosing  to not use the medication.                                                               
The beauty  of that for both  those who ultimately choose  to use                                                               
the medication  and those  who do not,  is that  throughout their                                                               
dying process  they have the  peace of  mind of knowing  that the                                                               
option  is   available  if  and  when   their  suffering  becomes                                                               
unbearable.  These people are then  able to stop spending so much                                                               
of their  precious remaining time  in dread and worry  about some                                                               
of the  "what if's" and  instead they can savor  whatever quality                                                               
of  life they  might otherwise  enjoy  in their  final weeks  and                                                               
days.    Alaskans  highly  value   individual  rights  and  self-                                                               
determination,  yet  the  state   laws  currently  deny  mentally                                                               
competent  adults who  are  already  in the  midst  of the  dying                                                               
process, the right  to avail themselves, if they so  choose, of a                                                               
liberty they would have had if  they resided in a number of other                                                               
states and  the right to  have some  control over the  timing and                                                               
manner  in which  their impending  death would  ultimately occur.                                                               
She  noted that  from everything  she  has read  about the  track                                                               
record  of Death  with Dignity  laws in  states that  have it  in                                                               
place, there  is just simply no  evidence of the sorts  of abuses                                                               
that some  who oppose  this legislation put  forth as  reasons to                                                               
deny this right to the  terminally ill.  Furthermore, she stated,                                                               
this  bill  puts  a  lot of  carefully  designed  provisions  and                                                               
safeguards in  place to  provide both  rights and  protections to                                                               
the terminally ill,  and some of those are so  burdensome that it                                                               
would  actually keep  people, especially  in  rural Alaska  where                                                               
medical providers  are limited, from availing  themselves of this                                                               
potential  law.   She understands  that having  so many  level of                                                               
protections in  place is  meant to  alleviate any  concerns about                                                               
potential shortcutting  or abuse  of the process,  she said.   To                                                               
the  extent possible,  she remarked  that  she believes  Alaska's                                                               
state laws should ensure that Alaskans  are able to live with the                                                               
self-determination they hold so dear  and retain as much peace of                                                               
mind  as possible  until their  final breath  is drawn.   In  the                                                               
event HB 54 becomes law, no  terminally ill person will be forced                                                               
to use  its provisions if that  is their desire, but  not passing                                                               
this bill is  denying an Alaskan access to this  option for those                                                               
who desperately want it, appears to be inhuman and un-Alaskan.                                                                  
                                                                                                                                
6:50:22 PM                                                                                                                    
                                                                                                                                
ASHLEY CARDENAS,  Director, Policy  and Programs,  Compassion and                                                               
Choices,  advised that  Compassion  and Choices  is the  nation's                                                               
oldest and largest non-profit working  to improve care and expand                                                               
choices at the  end of life.  She related  that she is testifying                                                               
for Compassion  and Choices to lift  the voices of the  more than                                                               
1,200 Alaskan supporters across the  state, and to express strong                                                               
support for  lawmakers to authorize  medical Aid in Dying.   This                                                               
legislation is  modeled after  the State  of Oregon's  Death with                                                               
Dignity Act, which has been tested  and proven safe for more than                                                               
20  years.   Although, she  commented, opponents  may try  to use                                                               
scare tactics  and make the  same dire predictions raised  in the                                                               
State  of  Oregon  and  in  every  state  since,  to  deter  this                                                               
legislation.  The  facts demonstrate that for more  than 40 years                                                               
of combined practice  in the authorized states, the  laws do work                                                               
as  intended  as there  has  not  been one  single  substantiated                                                               
instance of  abuse.  To that  point, she said, she  would address                                                               
some inaccurate  claims that have  been heard and will  likely be                                                               
heard later  in today's testimony.   First, she said, there  is a                                                               
fundamental  difference between  the act  of committing  suicide,                                                               
which is often the tragic  result of an unrecognized or untreated                                                               
mental  health disease  such as  depression or  addiction, and  a                                                               
rational well-considered  decision to  advance the time  of death                                                               
in  the setting  of terminal  illness and  unrelenting suffering.                                                               
There is absolutely  no evidence that authorizing  medical Aid in                                                               
Dying increases the suicide rates  in any state, she advised, and                                                               
that suicide rates encompass ready  access to firearms, the rural                                                               
geography,  and   limited  access  to  mental   health  services.                                                               
Studies have shown  that the vast majority  of those misdiagnosis                                                               
are either  the result  of missed  diagnosis or  under diagnosis.                                                               
She pointed  out that rarely  is a terminal  diagnosis delivered,                                                               
let alone confirmed  by multiple physicians, when  the patient is                                                               
not  in  fact  terminally  ill.     Furthermore,  physicians  are                                                               
typically optimistic  in their estimate  of a  patient's survival                                                               
and  generally over-estimate  the  amount of  time  a patient  is                                                               
likely to  live.   In fact,  she offered,  one study  showed that                                                               
physicians  tend  to  over-estimate   by  at  least  five  times.                                                               
Additionally, she  advised, studies have  shown that there  is no                                                               
evidence of a heightened risk  for patients in vulnerable groups,                                                               
and insurance  companies have no financial  incentive to pressure                                                               
terminally patients  to accelerate their deaths  because there is                                                               
no potential cost  savings.  Decisions about death  belong to the                                                               
dying,  she  said, and  this  policy  allows  them to  have  open                                                               
conversations  with their  doctors, their  loved ones,  and their                                                               
faith leaders, about  their needs at the end of  their life.  The                                                               
decision to utilize medical Aid in  Dying is only one end of life                                                               
option, and for  those who are strongly opposed need  not opt for                                                               
the  medical  aid.    Except,   for  those  people  who  do  face                                                               
unbearable  suffering at  end of  their life,  this option  gives                                                               
them the courage  and the hope that allows them  to live fully as                                                               
long as possible,  and to die peacefully when  death is imminent,                                                               
she pointed out.                                                                                                                
                                                                                                                                
6:54:02 PM                                                                                                                    
                                                                                                                                
DAVID GRUBE,  M.D., Compassion and  Choices, advised that  he was                                                               
raised in Fairbanks  and graduated from Lathrup  High School, and                                                               
he  has practiced  in  a  small town  in  Oregon from  1977-2012.                                                               
During 15 of those years, Oregon's  Death with Dignity Act was in                                                               
force,  which  is similar  to  HB  54, and  he  had  a number  of                                                               
terminally ill,  dying and  suffering patients  who asked  him to                                                               
support  their choice  at  their  end of  life.    Contrary to  a                                                               
previous testifier,  who is  not a  clinician and  is not  at the                                                               
bedsides  of dying  patients, Aid  in Dying  is a  deliberate and                                                               
careful act.   Doctors do not allow patients to  use this process                                                               
because they are  diabetic or because they just want  to die.  In                                                               
fact, he pointed  out, when reviewing the State  of Oregon's data                                                               
and  experience, 95  percent  of  Aid in  Dying  patients are  in                                                               
Hospice and  are receiving Hospice's  excellent quality  of care.                                                               
He  stated that  he knows  for  a fact  that  Aid in  Dying is  a                                                               
palliative opportunity in and of  itself because when people have                                                               
an opportunity to talk to their  doctor about all of their end of                                                               
life choices, it  is palliative and they suffer less.   Dr. Grube                                                               
pointed  out that  more people  have  not died  since Death  with                                                               
Dignity was passed in the State  of Oregon, and all of the people                                                               
who used  Aid in Dying  were about to  die and fewer  people have                                                               
suffered.   He  related  that he  hopes that  is  true for  those                                                               
terminally ill and  suffering Alaskans, they can  write their own                                                               
final chapter and be allowed to not suffer.                                                                                     
                                                                                                                                
6:56:48 PM                                                                                                                    
                                                                                                                                
JEANNE ANDERSON, M.D.,  advised that she is  a medical oncologist                                                               
who has  taken care of cancer  patients for almost 30  years, and                                                               
she is  strongly against HB 54.   She stated that  doctors cannot                                                               
prognostic and predict  that someone has less than  six months to                                                               
live.   Statistics offer an  approximate average of  survivals as                                                               
to how long patients might  live, those statistics are data based                                                               
on   historical   treatment   protocols   and   are   notoriously                                                               
inaccurate.   For  example, she  said,  David White  had stage  4                                                               
bladder cancer  in 2014, and  if he  asked her to  participate in                                                               
this end-of-life  program, at  that point she  would have  had to                                                               
predict that  he had  less than  six months to  live.   Mr. White                                                               
chose to go on  a clinical trial and he has  been alive for three                                                               
years without  evidence of his  cancer.  Another  patient, Donald                                                               
Dunkleburger,  had a  (audio difficulties)  lymphoma in  2015, he                                                               
did not  respond to any  of his chemotherapy treatments,  he flew                                                               
to Seattle  for a  bone marrow transplant  and the  experts there                                                               
advised that  he could not  have the transplant because  he would                                                               
not  respond.   Mr.  Dunkleburger returned  home, any  oncologist                                                               
would have  predicted that he had  less than six months  to live,                                                               
he chose to  go home and not undergo further  treatments, and two                                                               
years  later he  is still  alive with  a normal  quality of  life                                                               
without  active  lymphoma.    Those are  examples  to  show  that                                                               
doctors  cannot prognosticate,  she advised,  and for  this is  a                                                               
group of  people being  targeted, doctors have  no clue  how long                                                               
they will  live.  When someone  is imminently dying with  days to                                                               
weeks, or  hours to days,  to live it  is then easy  to determine                                                               
which  is when  doctors need  to  relieve their  suffering.   She                                                               
offered  her belief  that  people make  an  excellent point  that                                                               
suffering needs  to be relieved and  that there are many  ways in                                                               
which to  relieve suffering.   In the event there  is existential                                                               
suffering, patients need  help for that, but they do  not need to                                                               
take some  treatment that  ends their life  before they  have had                                                               
the opportunity to close ends  with family members, and so forth.                                                               
There  are palliative  care teams  (audio difficulties)  services                                                               
within the  community that can  support people going  through the                                                               
difficult  process.    There  is  an  unintended  consequence  of                                                               
financial (audio difficulties).                                                                                                 
                                                                                                                                
6:59:33 PM                                                                                                                    
                                                                                                                                
RICHARD ASHER, M.D., advised that  he has lived in Dillingham for                                                               
over 30  years and he  cares for people  in rural villages.   His                                                               
desire, he  said, is (audio  difficulties) assisted  suicide will                                                               
not be passed.   Physicians and practitioners  are better trained                                                               
in relieving pain and comforting  suffering patients with Hospice                                                               
and palliative  care in rural  communities.  Care is  provided to                                                               
patients  in  terminal  situations  and currently  pain  is  much                                                               
better  relieved than  in the  past.   Dangers are  involved when                                                               
physicians walk  away from  the traditional  (audio difficulties)                                                               
causing harm to  a patient (audio difficulties).   Physicians and                                                               
nurses can (audio  difficulties) as they face death  and care for                                                               
them in  tough situations.   On the  other hand, he  said, (audio                                                               
difficulties)  think is  going  to  happen (audio  difficulties).                                                               
Alaska has a high suicide rate,  and a person who is depressed or                                                               
ill (audio  difficulties) dealing  with life's difficulties.   He                                                               
urged  the committee  to (audio  difficulties) this  bill because                                                               
physicians  and other  health care  providers will  be harmed  by                                                               
assisting patients in this endeavor.                                                                                            
                                                                                                                                
7:01:14 PM                                                                                                                    
                                                                                                                                
LAURINDA MARCELLO  urged the committee to  advance and eventually                                                               
pass HB  54.   She advised  that the  summer after  she graduated                                                               
from  high  school, her  family  changed  completely because  her                                                               
father,   a   middle-aged   college  chemistry   professor,   was                                                               
unexpectantly  diagnosed  with  terminal  cancer  and  scans  had                                                               
located tumors  throughout the critical  areas of his body.   Her                                                               
father opted for  palliative comfort care and he  died just three                                                               
weeks after his  initial diagnosis.  During that  short period of                                                               
time  much  happened  to  diminish  his  quality  of  life  which                                                               
included a  serious infection, being  medevacked to  Seattle, and                                                               
losing his independence.  Although  her father was able to return                                                               
to Sitka,  he carried the emotional  burden of not being  able to                                                               
return to  his own home due  to his health.   During her father's                                                               
final several days,  he faced the type of pain  that not even the                                                               
maximum allowable  dosage of  morphine could  erase.   The (audio                                                               
difficulties) progression  of (audio difficulties)  precluded her                                                               
father from actually  seeing a Death with Dignity  law in Alaska.                                                               
This proposed law  contains a reasonable waiting  period in order                                                               
to avoid misuse; however, she  said, she takes comfort in knowing                                                               
that  other terminally  ill Alaskans  could be  helped by  HB 54.                                                               
Oftentimes, terminally ill people  have months to contemplate and                                                               
plan for  their death,  and unfortunately  that extra  time often                                                               
comes with a  prolonged period of agony.  She  related that it is                                                               
her greatest hope that the  legislature will offer its terminally                                                               
ill  residents  the   option  to  die  with   the  assistance  of                                                               
medication, and  she asked the  committee to support  the passage                                                               
of HB 54.                                                                                                                       
                                                                                                                                
7:02:52 PM                                                                                                                    
                                                                                                                                
LUKE  LIU,  M.D.,  advised  that he  is  an  interventional  pain                                                               
physician and  he is  opposed to HB  54 because  this legislation                                                               
permits  assisted  suicide  and  euthanasia  for  terminally  ill                                                               
patients.   He offered that  he shares Dr.  Anderson's testimony,                                                               
her  respect for  the  expectancy of  life,  and her  progressive                                                               
optimism  over   advancing  community  medical  care.     In  his                                                               
experience  as   an  anesthesiologist  and   interventional  pain                                                               
physician, he pointed out that  he has encountered numerous cases                                                               
wherein  medical teams  were  wrong in  their  assessment of  the                                                               
survival duration  for a patient.   Doctors are not right  all of                                                               
the time,  he stressed.  In  the event the justice  system (audio                                                               
difficulties)  innocent  until   proven  guilty  and  erroneously                                                               
imprison  the wrongly  accused.   How much  more detrimental,  he                                                               
asked,  are the  consequences  when a  terminally  ill person  is                                                               
wrongfully  diagnosed  with  a limited  survival  duration.    He                                                               
offered  that  he  does  not   think  anyone,  including  medical                                                               
doctors,  should  be  given  such  power  to  definitively  limit                                                               
another  person's  life  expectancy.   Within  his  practice,  he                                                               
remarked, (audio  difficulties) patients.   Particularly patients                                                               
with cancer  pain wherein many  of these modalities  involve non-                                                               
opioid therapeutic  options.   He pointed  out that  the constant                                                               
advances in matters of terminal  illnesses offer more alternative                                                               
treatment  options,  other  than   morphine  drips  and  morphine                                                               
infusions.   Currently, terminally  ill patients are  enrolled in                                                               
Hospice,  and its  very mission  is to  ease their  suffering and                                                               
possibly hasten  an inevitable and  certain death.  He  asked why                                                               
the state needs something outside  of the defined confines of the                                                               
well established  medical specialty of Hospice  to introduce some                                                               
(audio difficulties) negative social  certainties when the nation                                                               
and the state  are currently in an opioid epidemic.   He stressed                                                               
that   he  is   opposed  to   giving  medical   providers  (audio                                                               
difficulties); therefore, he is opposed to HB 54.                                                                               
                                                                                                                                
7:05:31 PM                                                                                                                    
                                                                                                                                
SUSAN SCHRADER  advised that she  has lived in Juneau  for almost                                                               
30 years, offered her full support  for HB 54, and encouraged the                                                               
committee's support  for the legislation.   She related  that she                                                               
is unsure  as to what she  could say that would  change the minds                                                               
of those who are opposed to giving (audio difficulties).                                                                        
                                                                                                                                
7:07:17 PM                                                                                                                    
                                                                                                                                
CHERYL BOWIE  advised that she  opposes HB 54, and  the testimony                                                               
using completely different geographic areas  as a way to show how                                                               
a policy would  have permanent impacts on a rural  state versus a                                                               
different   state   with   multiple   options   for   healthcare,                                                               
transportation, and funding.   She said, "We  do pride ourselves"                                                               
on  striving to  achieve self-determination,  but oftentimes  "we                                                               
limit what our choices are."   She remarked that she has personal                                                               
and  professional experience  wherein she  has suffered  multiple                                                               
and painful  medical conditions  the majority of  her life.   She                                                               
offered that, "I have also  worked for two medical directors, one                                                               
for  the  federal  government  and one  for  a  highly  regulated                                                               
environment working in the oil field  industry."  She said she is                                                               
a "previous liver  disease fellow," and completed  a two semester                                                               
practicum at  Indian Health Service  Continuing Education  in the                                                               
1990s.   She related that  she values life and  before legalizing                                                               
something when  this state is  facing massive  unemployment, huge                                                               
amounts of depression, drug abuse,  suicide, and limited options,                                                               
this bill  carries the  wrong message.   As much  as she  has not                                                               
enjoyed  the  "things  I've  had  to endure  in  my  own  medical                                                               
history,"  (audio difficulties)  she has  learned lessons  in her                                                               
life as  someone suffering with  multiple health  conditions, and                                                               
she  was  in  severe  pain  before she  started  using  a  (audio                                                               
difficulties).                                                                                                                  
                                                                                                                                
7:09:57 PM                                                                                                                    
                                                                                                                                
JOEL  HANSON  urged  the  committee to  support  the  Death  with                                                               
Dignity legislation.   Similar to many people in  their late 60s,                                                               
he has  some personal knowledge  and experience  with end-of-life                                                               
issues.   He offered  that his  father died  almost 30  years ago                                                               
from  cancer,  and all  of  his  family  spent time  helping  him                                                               
through a prolonged and difficult  period of deteriorating health                                                               
at home.   His  father eventually  died hooked  up to  a morphine                                                               
pump, which he  needed in order to keep his  pain in check during                                                               
his  last few  months.   Fifteen years  ago, his  mother died  of                                                               
cancer, in  pain, and at home  with her children at  her bedside.                                                               
He noted  that he listened to  a recording of the  hearing in the                                                               
House Health  and Social Services Standing  Committee on 1/30/18.                                                               
He  telephonically thanked  the  supporters of  this bill  during                                                               
that  hearing, and  he now  offered  his thanks  again for  their                                                               
efforts.   These end-of-life  issues are not  easy to  deal with,                                                               
"but deal with  them we must, both personally and  as a society."                                                               
He remarked to those who  opposed this legislation in January and                                                               
to those in opposition today, it  is the epidemy of cruelty for a                                                               
person  to force  agony on  another  person simply  due to  their                                                               
religious or  ethical belief  in the  sanctity of  life.   In the                                                               
event  this  is "your  position"  as  it  was  for the  only  two                                                               
objectors  at the  January hearing,  (audio  difficulties) is  in                                                               
effect condemning someone else to  suffer pain in order to "avoid                                                               
subjecting yourself to  nothing more than a  measure of doctrinal                                                               
or  ethical distress  ... Call  it whatever  you want,  but don't                                                               
call  your   position  a  commitment   of  your  devotion   to  a                                                               
compassionate God or a higher moral sense.   No.  Call it what it                                                               
is, a  commitment to  prolonging human  anguish.   I have  my own                                                               
confession, if I find myself near  my own life's end, in the same                                                               
kind  of shape  my  parents were  before their  death,  I have  a                                                               
backup  plan.   It  won't  be the  most  dignified solution,  but                                                               
absent a  legally sanctioned pharmaceutical alternative,  it will                                                               
be better than suffering and  possibly causing those around me to                                                               
suffer.   I know  what that's  like."  He  related his  hope that                                                               
those  representatives  who are  still  undecided  on Death  with                                                               
Dignity, will give  some thought to the fact that  at least a few                                                               
elderly and  seriously unwell Alaskans  choose to take  their own                                                               
lives every year (audio difficulties).                                                                                          
                                                                                                                                
7:12:29 PM                                                                                                                    
                                                                                                                                
WILLIAM KENYON  advised that he  is age 76,  he is a  resident of                                                               
Cordova, and  one and  one-half years ago  he was  diagnosed with                                                               
idiopathic  pulmonary fibrosis,  which is  a terminal  diagnosis.                                                               
There is no  cure for this condition, he related,  he will slowly                                                               
lose his  ability to  breathe, and  near the end  of his  life he                                                               
will be  restricted to bed  care.  A friend  of his lived  in the                                                               
State of  Oregon, and  she died  of terminal  cancer.   Using the                                                               
Oregon law,  she went through  the process of being  approved for                                                               
medical Aid  in Dying.   Even though  his friend never  used that                                                               
help, her explanation to him was  that every day and every moment                                                               
she  was not  helpless because  she had  a valid  choice for  her                                                               
future, and that fact gave her a  great degree of peace.  As time                                                               
wore on,  through the pain and  discomfort she would put  off the                                                               
decision for the next day, and  she continued to live for another                                                               
day.   Even  though he  has  not yet  reached the  last weeks  or                                                               
months of his life, he stated  that he agrees with his friend and                                                               
with a clear mind,  he would like the right to  choose when it is                                                               
time for him to leave this world.                                                                                               
                                                                                                                                
7:14:00 PM                                                                                                                    
                                                                                                                                
MAUREEN  MOORE,   advised  that   she  lives  in   Juneau  (audio                                                               
difficulties) seriously  makes plans  for the  end and  she would                                                               
rather (audio  difficulties) state that she  loves, surrounded by                                                               
the  people she  cares about  at  the end  of her  life.   (Audio                                                               
difficulties) Hospice  trainer for  (audio difficulties)  and she                                                               
would certainly  like to have that  choice at the end  of her day                                                               
and not leave  her family with (audio  difficulties) of suffering                                                               
that  do not  easily disappear.   (Audio  difficulties) mine  are                                                               
valuable  and she  asked  the committee  to  please support  this                                                               
legislation  and   move  it  to   the  floor  of  the   House  of                                                               
Representatives this year.                                                                                                      
                                                                                                                                
7:16:11 PM                                                                                                                    
                                                                                                                                
CHAIR  CLAMAN,  after  ascertaining  no one  wished  to  testify,                                                               
closed public testimony on HB 54.                                                                                               
                                                                                                                                
[HB 54 was held over.]                                                                                                          

Document Name Date/Time Subjects
SJR004 ver U 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Sponsor Statement 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Summary of Changes 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-April 2018 Sen. Olson HCRA Memo Fed Legis S.1965 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Jan. 2018 S Olson Memo Walrus Protection Status 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-MMPA Section 101 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Oregon Statutes 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-California Statutes 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Feb 2017 LA Times Article Enforcement Ivory Ban 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Hawaii Statutes 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-New York Statutes 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Washington Statutes 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Congress.com April 2018 S.1965 115 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Document-Feb. 2018 KTUU Online Etsy Bans Ivory 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Additional Documents-MMPA Section 109 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
SJR004 Fiscal Note LEG-SESS 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
SJR 4
HB054 ver U 4.13.18.PDF HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Sponsor Statement 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Alaska End of Life Survey 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Girdwood Board Of Supervisors Resolution of Support 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Juneau Op Ed Letter 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Kodiak Daily Mirror - Local Advocates for Medical Aid in Dying law 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-California Healthline Article - Docs In Northwest Tweak Aid-In-Dying Drugs To Prevent Prolonged Deaths 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Washington Post Opinion - Archbishop Tutu 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Oregon & the Netherlands Research 2007 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Fiscal Note LAW-CIV 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Fiscal Note DHSS-BVS 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB075 Amendments #1-21.pdf HJUD 4/13/2018 1:00:00 PM
HB 75
HB054 Sectional Analysis 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Opposing Document-ADN Opinion 4.13.18.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Supporting Document-Letters & Public Comment.pdf HJUD 4/13/2018 1:00:00 PM
HB 54
HB054 Opposing Document-Letters & Public Comment.pdf HJUD 4/13/2018 1:00:00 PM
HB 54